Xciting times for Cardiologs at HRX
For 3 days, physicians, nurses, scientists, engineers and industry leaders came together in San Diego for the digital health summit organized by the Heart Rhythm Society. The HRX 2022 event took place in a single open space, with a center stage for orators to give their presentations to the audience in a “silent disco” mode. Attendees were able to choose the channel on their headsets related to the content stream of their choice, including Health Tech: Digital and Beyond, Health Data: Acquisition and Management and Digital Health Boot Camp.
For Cardiologs, it was the perfect setting to talk about the emerging digital trend of Remote Patient Monitoring (RPM), the opportunities it represents and the future outlook.
In case you missed it, don’t worry! We have it all covered below.
Abstract presentation by Dr. William Keen, Chief of Cardiology, Health Nucleus
The abstract, entitled “A new digital solution to unlock the potential of smart wearables for remote patient cardiac monitoring¹” was presented by Dr. William Keen, Chief of Cardiology at Health Nucleus.
He shared his experience using Cardiologs RPM² in his daily practice to diagnose and monitor his patients. The benefits he described were twofold: From a workflow perspective, actionable data is centralized and triaged automatically, allowing him to view patient information at a glance. From a clinical standpoint, the technology supports both the diagnosis of infrequent arrhythmia and monitoring of patients’ response to treatment.
Out of 90 patients enrolled in the program, he focused on two clinical cases where Cardiologs RPM allowed him to deliver data-driven personalized care, at the right time:
- On one side, the diagnosis of supraventricular tachyarrhythmia (PSVT) in a patient with infrequent palpitations for many years who could not be diagnosed with traditional cardiac monitoring techniques. She got an ablation and has not experienced any palpitations since then.
- On the other side, remotely monitoring a patient with atrial flutter, using ECGs he recorded on his smartwatch to detect recurrent flutter episodes and optimize the dosage of anti-arrhythmic drugs, thus avoiding emergency room visits.
Dr. Suneet Mittal, Director of Electrophysiology and Associate Chief of Cardiology at the Valley Hospital in Ridgewood, asked about the cost, the limitations and the scalability of the solution, to which Dr. Keen responded that, since patients bring their own devices, there are no additional costs and the center could eventually ask for RPM reimbursement³. Additionally, the fact that Cardiologs RPM triages the data makes reviews easy and quick and therefore manageable for thousands of patients at the same time.
— Cardiologs (@CardioLogs) September 10, 2022
Roundtable: “Addressing the deluge of wearables data with RPM digital solutions: Sharing best practice and clinical use cases”
We hosted a roundtable on “Addressing the deluge of wearables data with RPM digital solutions: Sharing best practice and clinical use cases”. Amongst the attendees, Dr. Suneet Mittal, Dr. Janet Han, Dr. Kamala Tamirisa, Dr. Jag Singh, Dr. Rod Passman and Mrs. Martha Ferrara gathered to discuss several interesting topics including the increasing number of devices and platforms available, forcing them to get training on different solutions and keep track of updates.
They feel they have a sense of responsibility in the choice of the solution proposed to the patient, therefore they need the industry to provide evidence and support as innovation is growing fast, alleviating them from this burden and allowing them to vet for proven solutions.
This leads to another important discussion on the connectivity between smart wearable devices and their platforms to ensure they do not miss any patient information that’s being transferred. And how an integration into the Electronic Health Records (EHR) would be ideal.
One important aspect, where Cardiologs RPM comes into play, is that devices and platforms should be agnostic and work in a way that they can gather all the data and information in one place. Whether the data comes from smartwatches, wearables or handheld devices, centralization is a must. Today, Cardiologs RPM is compatible with Apple Watches, but in the near future, additional integrations will be part of the solution.
There’s still a long way ahead before RPM becomes a standard practice and physicians need additional support to engage with administrations and governmental bodies in order to demonstrate the true value digital tools can bring through education and clinical trials.
Thoughtful discussion on addressing the deluge of wearables data with remote patient monitoring (RPM) at #HRX2022
Three themes that merit further discussion
💗Good AI that sorts noise from actionable RPM data
💗Clinic workflows for RPM
💗RPM technology that is patient-centric pic.twitter.com/vvbd2XK4ha
— Kashvi Gupta (@KashviGupta) September 9, 2022
Crash course: “Wearables for physiological Monitoring – The state of Science”
Dr. Laurent Fiorina, Electrophysiologist at the Institut Cardiovasculaire Paris-Sud (ICPS) and Medical Expert at Cardiologs, took part in the crash course on the evolution of wearable solutions, their clinical impact and their potential in the future. He has been working with Cardiologs since 2014, bringing his expertise in cardiology and electrophysiology. He was one of the first to see the potential of the Cardiologs AI technology applied to ambulatory ECG.
He spoke about his experience where patients had to wait several months in order to receive the results of their extended Holter back to know if they had experienced episodes of atrial fibrillation (AFib). Since they started using the Cardiologs Holter platform⁴ at the ICPS, “patients receive their reports in less than 24 hours”.
According to him, electrocardiogram analysis solutions embedded in smartwatches and handhelds have had significant impact in recent years. Since their introduction, the team at the ICPS began receiving numerous emails from patients asking for interpretation of the ECG they had recorded with their own device. Patients are taking steps in being more involved in their own care to the extent that some would bring their own smart wearable to their consultations.
This is when the concept for Cardiologs RPM, a vendor-neutral platform to centralize ECG data, came to light.
He talked about “democratic disruption” and the fact that technological innovations are not always driven by clinicians and clinical needs but by the general population. Technology is developing fast, even faster than evidence-based medicine and thus bringing great opportunities when it comes to screening healthy patients in order to prevent heart diseases.
From his standpoint, “we will soon be able to see in ECGs what a human eye cannot see, that is: the arrhythmia before it occurs. AI prediction algorithms and biomarkers are the real future of wearables. We are moving slowly – or maybe not so slowly – from curative medicine to preventive medicine.”
Our latest Cardiologs study “Short-term prediction of atrial fibrillation from ambulatory monitoring ECG using a deep neural network⁵”, in collaboration with Dr. Jagmeet Singh, Cardiologist at Massachusetts General Hospital (MGH) and Professor of Medicine at Harvard Medical School, provided the first evidence that a deep learning algorithm can predict the occurrence of atrial fibrillation within two weeks by processing 24-hour Holter recordings showing sinus rhythm.
Group chat: “The Healthcare professional perspective: What are our challenges with RPM”
According to Dr. Fiorina, the biggest challenge clinicians face with RPM would have to be the increasing use of wearables and the amount of inconclusive results their algorithms generate. In order to tackle this issue, Artificial Intelligence is crucial to help reduce those inconclusive results as presented in the Cardiologs study⁶ presented at EHRA 2022.
The study demonstrated that the Apple Watch ECG 2.0 App yielded inconclusive diagnoses for 19% (19/101) of all smartwatch recordings. In comparison, Cardiologs’ deep neural network reduced that number to 0% (0/101) while maintaining performance in accuracy, specificity and sensitivity. These results offer great promise for using smartwatches to screen for irregular heart rhythms.
— Cardiologs (@CardioLogs) September 9, 2022
All in all, HRX 2022 was a huge success! It was great to see everyone come together with one common purpose to “transform cardiovascular patient care through digital health innovation and collaboration.”
For more information about Cardiologs RPM, visit our product page.
We look forward to seeing everyone again next year in Seattle.
This material reflects the opinion of Healthcare Professionals, not the opinion of Cardiologs.
1. A new digital solution to unlock the potential of smart wearables for remote patient cardiac monitoring https://doi.org/10.1016/j.cvdhj.2022.07.043
2. The Cardiologs RPM solution is available as a limited market release in the US and the EU.
3. Reimbursement varies by geographic locality and payers. There is no statement, promise or guarantee by Cardiologs concerning coverage of services. It is the provider’s responsibility to consult with certified billing and coding professionals and to determine accurate coding, coverage and claim information for the services that were provided.
4. The Cardiologs Holter Platform is a medical device intended for use by qualified healthcare professionals for the assessment of arrhythmias using ECG data in subjects over 18 years of age. Class IIa in Europe (CE2797) in compliance with the Medical Device Directive (MM 93/42/EEC amended by 2007/47/EC). Class II in the USA according to the 510K clearance.
5. Jagmeet P Singh, Julien Fontanarava, Grégoire de Massé, Tanner Carbonati, Jia Li, Christine Henry, Laurent Fiorina, Short-term prediction of atrial fibrillation from ambulatory monitoring ECG using a deep neural network, European Heart Journal – Digital Health, Volume 3, Issue 2, June 2022, Pages 208–217, https://doi.org/10.1093/ehjdh/ztac014
6. Fiorina L et al. (2022) Smartwatch-based detection of atrial arrhythmia using a deep neural network in a tertiary care hospital. Europace, 24(Supplement_1), euac053-563.